Provider Demographics
NPI:1528199114
Name:BROWN, AMY SUSZKO (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:SUSZKO
Last Name:BROWN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 OAK ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-1486
Mailing Address - Country:US
Mailing Address - Phone:708-955-8070
Mailing Address - Fax:
Practice Address - Street 1:15 OAK ST STE 2B
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1486
Practice Address - Country:US
Practice Address - Phone:708-955-8070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005567103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical